Botenya ba hypoventilation syndrome (OHS)

Obesity hypoventilation syndrome (OHS) ke boemo ho batho ba bang ba batenya haholo moo ho hema hampe ho lebisang ho tlase ha oksijene le maemong a phahameng a carbon dioxide maling.

Lebaka le tobileng la OHS ha le tsejoe. Bafuputsi ba lumela hore OHS e hlaha ka lebaka la bofokoli bo taolong ea boko mabapi le ho hema. Boima bo feteletseng khahlanong le lebota la sefuba le hona ho thatafaletsa mesifa ho hema haholo le ho hema kapele ka ho lekana. Sena se mpefatsa taolo ea ho hema ea boko. Ka lebaka leo, mali a na le carbon dioxide e ngata le oksijene e sa lekaneng.

Matšoao a mantlha a OHS a bakoa ke ho hloka boroko mme a kenyelletsa:

• Boleng bo bobe ba ho robala
• Ho koaleha moea ka nakoana borokong
• Ho robala mots'eare
• Ho tepella maikutlo
• Ho tšoaroa ke hlooho
• Ho kgathala

Matšoao a boemo bo tlase ba mali a oksijene (a sa foleng a hypoxia) le ona a ka hlaha. Matšoao a kenyelletsa ho hema kapele kapa ho ikutloa u khathetse kamora ho etsa boiteko bo fokolang.

Batho ba nang le OHS hangata ba nonne haholo. Tlhahlobo ea 'mele e ka senola:

• Mmala o boputsoa molomong, menoaneng, menoaneng, kapa letlalong (cyanosis)
• Letlalo le bofubelu
• Matšoao a ho hloleha ha pelo ka lehlakoreng le letona (cor pulmonale), joalo ka maoto a ho ruruha kapa maoto, phefumoloho e khuts'oane, kapa ho ikutloa u khathetse kamora boiteko bo bonyenyane
• Matšoao a boroko bo feteletseng

Liteko tse sebelisitsoeng ho thusa ho fumana le ho netefatsa OHS li kenyelletsa:

• Khase ea mali ea mali
• X-ray sefubeng kapa CT scan ho felisa lisosa tse ling tse ka bang teng
• Liteko tsa mosebetsi oa matšoafo (liteko tsa tšebetso ea pulmonary)
• Ho ithuta ka boroko (polysomnography)
• Echocardiogram (ultrasound ea pelo)

Bafani ba tlhokomelo ea bophelo ba ka bolella OHS ho tsoa ho koaleha moea ka nakoana borokong hobane motho ea nang le OHS o na le carbon dioxide e phahameng maling a hae ha a tsohile.

Kalafo e kenyelletsa thuso ea ho hema ka ho sebelisa mechini e ikhethang (mechanical ventilation). Khetho e kenyelletsa:

• Mechini e kenang e sa hlaseleng joalo ka khatello e tsoelang pele ea moea (CPAP) kapa khatello ea moea ea bilevel (BiPAP) ka mask e lumellanang hantle ka nko kapa nko le molomo (haholo bakeng sa boroko)
• Phekolo ea oksijene
• Ho hema ho thusa ka lesoba le molaleng (tracheostomy) bakeng sa linyeoe tse matla

Kalafo e qala sepetlele kapa e le mokuli ea tsoang kantle.

Mefuta e meng ea kalafo e etselitsoe ho theola boima ba 'mele, e ka fetolang OHS.

Ha e sa alafshoa, OHS e ka lebisa mathateng a tebileng a pelo le methapo ea mali, kholofalo e matla kapa lefu.

Mathata a OHS a amanang le ho hloka boroko a ka kenyelletsa:

• Ho sithabela maikutlo, ho ferekana, ho teneha kapele
• Kotsi e eketsehileng ea likotsi kapa liphoso mosebetsing
• Mathata le kamano e haufi-ufi le thobalano

OHS e ka baka mathata a pelo joalo ka:

• Khatello ea mali e phahameng (hypertension)
• Ho hloleha ha pelo ka lehlakoreng le letona (cor pulmonale)
• Khatello ea mali e phahameng matšoafong (khatello ea methapo ea mali)

Bitsa mofani oa hau haeba u khathetse haholo motšehare kapa u na le matšoao a mang a fanang ka maikutlo a OHS.

Boloka boima ba 'mele bo phetseng hantle' me u qobe botenya. Sebelisa kalafo ea hau ea CPAP kapa BiPAP joalo ka ha mofani oa litšebeletso a laetse.

Matšoao a Pickwickian

• Tsamaiso ea phefumoloho

Malhotra A, Powell F. Mathata a taolo ea moea. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 26th. Philadelphia, PA: Elsevier; 2020: khaolo ea 80.

Mokhlesi B. Botenya-hypoventilation lefu. Ka: Kryger M, Roth T, Dement WC, bahlophisi. Melao-motheo le Tloaelo ea Meriana ea Boroko. La 6th. Philadelphia, PA: Elsevier; 2017: khaolo ea 120.

Mokhlesi B, Masa JF, Brozek JL, et al. Tlhatlhobo le taolo ea botenya ba hypoventilation syndrome. Tataiso ea semmuso ea Mokhatlo oa Amerika oa Thoracic. Am J Phefumoloho ea Tlhokomelo ea Med. 2019; 200 (3): e6-e24. PMID: 31368798 www.ncbi.nlm.nih.gov/pubmed/31368798.